Symptoms and signs in interpreting gamma-hydroxybutyrate (GHB) intoxication - an explorative
study
Sammanfattning
BACKGROUND:
Acute poisoning with gamma-hydroxybutyrate (GHB) has been a serious medical and social problem
in different parts of the world including Sweden. GHB is a drug of abuse which acts primarily as
central nervous system (CNS) depressants. GHB has serious toxicity, although many young users do
not recognise GHB as a dangerous drug. The aim of this pilot study was to explore how symptoms
with risk of failure in vital functions would be valued among professionals that encounter GHB
intoxication in the emergency phase.
METHODS:
A web-based survey focusing on the assessment of vital clinical signs for possible GHB intoxication
using a numeric scale was carried out during April and May 2011. The participants, n 105, are all
professionals who encounter GHB intoxicated in the emergency phase, but have different levels of
training in GHB intoxication, mainly Registered Nurses (RNs) in southwest Sweden, employed in
pre-hospital or emergency departments at somatic and most psychiatric health care facilities, as well
as police officers who in their work come into contact with drug users. Responses in the survey were
scored according to risk of GHB intoxication with serious failure of vital functions. The score value
was then referred to a so-called evidence based priority (EBP) scale and analysed using descriptive
statistics and Fisher's exact test.
RESULTS:
Cardiac arrest, coma, hypoxia, general convulsions, slow respiratory and heart rate and pale skin are
symptoms with the highest risk of serious failure in vital physical functions and were predominantly
recognised as such.
CONCLUSION:
Despite the professionals' different levels of training in GHB intoxication, all of them were relatively
well aware of and in accordance regarding the most risky symptoms. The interpretation score for the
less risky symptoms and signs of GHB intoxication varied depending on their degree of training. The
results should be viewed cautiously, as the size of the professional groups and their general
knowledge of critical symptoms of GHB poisoning varied.